FACILITY ACCESS AUTHORIZATION REQUEST
Form Instructions
- Enter the name of the individual requesting access authorization
- Enter the PSU-ID (employees) or Driver's License number (non-employees), as applicable
- Enter the phone number of the Requestor, including area code
- Enter the requestors' email address
- Enter the requestors' college, campus, department (employee) or company name (non-employee)
- Specify the area(s) where the requestor needs access, providing details such as building name(s), floor(s), room number(s) and/or other defining details
- Provide clear details specifying WHY the requestor requires access to said locations. Attach explanatory details if needed
- Select the start date of access
- If temporary request, select the end date of access. If permanent request, leave this field blank
- Enter the hours of access (i.e., 8:00 am - 5:00 p.m.)
- Check all days of the week on which access is required
- The requestor must provide either a hand-written signature or provide their digital ID
- Select the date access is issued
- This field is only completed when access is removed
- Enter the name of the requestors' supervisor (employee) or sponsor (non-employee)
- The Supervisor/Sponsor must provide either a hand-written signature or their digital ID
- Enter the name of the Access Coordinator granting access
- The Access Coordinator must provide either a hand-written signature or provide their digital ID
- The Access Coordinator checks the Key(s) box if issuing keys and completed the Key Issuance Log
- The Access Coordinator checks the Electronic Access box if issuing electronic access
- The Access Coordinator records any device numbers
